Case-based Approach to Clinical Pharmacology for Sleep and Neuromuscular Disorders in Horses

Presentation Description / Summary: This session will be case based to get insight to the pharmacologic management of sleep and neuromuscular disorders; two areas where therapeutic options are often limited and evidence is still emerging. Furthermore, the lack of recognition and definition of sleep disorders poses the major challenge in the management of disease. We will begin by providing examples of altered sleep such deprivation, excessive drowsiness, and narcolepsy-like. The pharmacologic effects of sedatives, anxiolytics, and other centrally acting agents will be reviewed, with emphasis on how they might influence sleep, behavior, and patient safety. The discussion will then turn to neuromuscular disorders affecting the neuromuscular junction (presynaptic, synaptic space, postsynaptic areas). We will review function of the neuromuscular junction and drugs that modulate its function. Pharmacokinetics and pharmacodynamic data to optimize therapeutic efficacy and minimize adverse effects will be revised in equids. Where equine-specific data are lacking, we will review available data from human and small animal species with similar neurologic conditions to possibly identify emerging therapeutic strategies. These comparisons will not only broaden the pharmacologic framework for equine clinicians but also highlight potential research directions. Lack of definition and understanding of neurologic disorders in equids, limited therapeutic options, unknown pharmacokinetics including safety and efficacy, and regulatory and ethical considerations pose a medical challenge for the management of various neurologic disorders.